Utah Code § 49-20-422

Current through the 2024 Fourth Special Session

Section 49-20-422 - Coverage of pregnancy and childbirth services, including doula, direct-entry midwife, and birthing center services

(1) As used in this section:

(a) "Doula" means an individual who:

(i) provides information and physical and emotional support:

(A) to a pregnant or postpartum individual; and

(B) related to the pregnant or postpartum individual's pregnancy; and

(ii) is certified by one or more organizations approved by the program.

(b) "Pregnancy and childbirth services" means services provided to a pregnant individual before, during, or shortly after childbirth:

(i) by a doula for the services described in Subsections (1)(a)(i) and (ii); and

(ii) at a birthing center that:

(A) is licensed under Title 26B, Chapter 2, Licensing and Certifications, or accredited by the Commission for the Accreditation of Birth Centers; and

(B) may include services by a direct-entry midwife licensed under Title 58, Chapter 77, Direct-Entry Midwife Act, if the direct-entry midwife is engaged in the practice of direct-entry midwifery, as defined in Section 58-77-102.

(c) "Qualified individual" means a covered individual who is:

(i) within the state employees' risk pool; and

(ii)

(A) is pregnant; or

(B) was pregnant within the past six months.

(2) For a plan year that begins on or after July 1, 2023, and before July 1, 2026, the program shall cover pregnancy and childbirth services to a qualified individual.

(3) The program may establish limits for coverage under Subsection (2), including limits based on:

(a) the type or number of services provided;

(b) a qualified individual's physical or emotional condition; and

(c) conditions for provider participation.

(4) The program shall report to the Health and Human Services Interim Committee on or before October 1 of each year regarding coverage provided under Subsection (2), including:

(a) covered providers;

(b) covered services;

(c) provider payment rates;

(d) covered-individual cost sharing;

(e) total provider payments and covered-individual cost sharing; and

(f) any indicators of whether pregnancy and childbirth services covered under Subsection (2) have:

(i) reduced pregnancy or postpartum coverage costs; or

(ii) improved pregnancy or postpartum care.

Utah Code § 49-20-422

Added by Chapter 292, 2023 General Session ,§ 1, eff. 5/3/2023.